Provider Demographics
NPI:1821249384
Name:LINDGREN, RYAN S (MSW)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:S
Last Name:LINDGREN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6804 WHISPERING FLS APT 23
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-2226
Mailing Address - Country:US
Mailing Address - Phone:801-472-6522
Mailing Address - Fax:
Practice Address - Street 1:6804 WHISPERING FLS APT 23
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-2226
Practice Address - Country:US
Practice Address - Phone:801-472-6522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0040461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical